Dowe, Deborah wrote:
> I don't have access to my usual info at this time and I need references for not using powdered formula for supplementing a premature baby.  Mother was told to add a 'scoop' of powdered formula to her expressed breastmilk at each feeding. Can someone please help?  Thanks.


Whoaaaaa!  When you say 'powdered formula', do you mean something that's 
been *designed* to be added to breastmilk, or do you mean the standard 
formula that's supposed to be mixed with water??

If the latter, then this is incredibly risky, and not just for premies. 
  The level of sodium and other substances in formula is worked out on 
the basis that it will be diluted with boiled water, which hardly 
contains any extra sodium.  Breastmilk already has enough sodium in it 
for the baby's requirements.  If normal powdered formula is mixed with 
breastmilk, the baby is getting *extra* sodium in proportion to the 
water content, which puts too much of a load on the kidneys and can lead 
to dangerously high sodium levels.  As in, potentially fatal.  Worse for 
a premie because their kidneys are still less mature, but dangerous for 
*any* baby.  Hell, never mind references, there should be something 
right there in the instructions on the formula tin saying you're not 
supposed to use any liquids other than water for reconstitution.

(Of course, it's possible I've totally misunderstood and you actually 
did mean the sort of supplement that's specially designed to be added to 
breastmilk for premies, with electrolytes measured to take this into 
account.  If so, then that's not a subject I know anything about, so 
ignore me.)


Best wishes,

Sarah Vaughan

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